NPIMap

Organization Active NPI

W.a. Foote Memorial Hospital, Inc.

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Jackson, MI
National Provider Identifier
1407948854
Registry record updated Apr 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Hospital UnitTaxonomy code 276400000X
Legal business name
W.A. FOOTE MEMORIAL HOSPITAL, INC.
Practice address
205 N. East Ave
7TH FL One Jackson Square
Jackson, MI 49201
Phone
(517) 788-4713
Fax
(517) 841-7419
NPI assigned
Sep 29, 2006
Organization subpart
Yes
Parent organization
W.A. FOOTE MEMORIAL HOSPITAL, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 1, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Jeanne M. Wickens
Title
Sr VP Finance/Cfo
Phone
(517) 841-6979

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Hospital Unit 276400000X Primary

Addresses

Primary practice location

205 N. East Ave
7TH FL One Jackson Square
Jackson, MI 49201

Mailing address

205 N. East Ave
7TH FL One Jackson Square
Jackson, MI 49201
Phone (517) 788-4713

Other identifiers 11

IdentifierTypeStateIssuer
045908OtherMIHEALTH ALLIANCE PLAN
100094OtherMIPREFERRED CHOICES
HL380002OtherMIMCARE
092063100MedicaidFL
030066700OtherMIUNITED MINE WORKERS
2855754MedicaidOH
00080OtherMIBLUE CARE NETWORK
01410125MedicaidKY
P100094OtherMIPREFERRED CARE CHOICES
20080OtherMIBLUE CROSS OF MICHIGAN
5020010OtherMIPHYSICIAN'S HEALTH PLAN

Other names 1

  • Henry Ford Allegiance Addiction Recovery Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Foote Emerg Phys104 organizations share this tax ID, including this one
Part of
Foote Emerg Phys

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459468800000",
    "number": "1407948854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 N. EAST AVE",
            "address_2": "7TH FL ONE JACKSON SQUARE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "49201",
            "telephone_number": "517-788-4713",
            "fax_number": "517-841-7419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N. EAST AVE",
            "address_2": "7TH FL ONE JACKSON SQUARE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "49201",
            "telephone_number": "517-788-4713",
            "fax_number": "517-841-7419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "W.A. FOOTE MEMORIAL HOSPITAL, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "W.A. FOOTE MEMORIAL HOSPITAL, INC.",
        "enumeration_date": "2006-09-29",
        "last_updated": "2016-04-01",
        "status": "A",
        "authorized_official_last_name": "WICKENS",
        "authorized_official_first_name": "JEANNE",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "SR VP FINANCE/CFO",
        "authorized_official_telephone_number": "517-841-6979",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "276400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation, Substance Use Disorder Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE PLAN",
            "identifier": "045908",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CHOICES",
            "identifier": "100094",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCARE",
            "identifier": "HL380002",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "092063100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED MINE WORKERS",
            "identifier": "030066700",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2855754",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE NETWORK",
            "identifier": "00080",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01410125",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE CHOICES",
            "identifier": "P100094",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF MICHIGAN",
            "identifier": "20080",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN'S HEALTH PLAN",
            "identifier": "5020010",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Henry Ford Allegiance Addiction Recovery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.